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Give Me Two Minutes, Doc

Study finds physicians would benefit from listening more to patients

THURSDAY, Sept. 26, 2002 (HealthDayNews) -- If you've ever felt rushed when trying to talk to your doctor, you're not alone.

American studies have shown that after 22 seconds, physicians tend to interrupt patients who are in the middle of explaining what has been bothering them.

As it turns out, doctors may be surprised to learn that if they let their patients express the reason for their office visit without interruption, most could do so with remarkable brevity.

According to a new Swiss study, most patients have finished their litany of complaints within two minutes.

Study author Dr. Wolf Langewitz, of University Hospital in Basle, says there are similar problems in his country.

"I estimate they (doctors) take the lead in 30 seconds. They'll ask, 'What about the cough?' or 'How high is the temperature?' Then the physician is asking questions and rarely giving the patient a chance to speak."

The researchers, whose study appears in the latest issue of the British Medical Journal, analyzed spontaneous talking time in 335 patients seen by 14 doctors. All patients were allowed to speak until they indicated they were done. Mean spontaneous talking time was 92 seconds, and all the information given, even things said in a roundabout fashion, was found to be important, Langewitz says.

"One patient talked 15 minutes, but the resident thought it was relevant," he says.

Physicians will find it to their benefit to let their patients talk, Langewitz adds.

"We don't want a patient who as soon as he goes out the door says, 'Oh, there's something else I wanted to say.' We can stick to our time schedule if we listen to them. We want to encourage physicians to wait. It won't take more than two minutes," he says.

David Stern, assistant director of the doctor-patient communication course at the University of Michigan Medical School, says, "Doctors tend to have a list of questions that they need to ask. One way is to pepper the patient with questions. Or let the patient tell you."

Stern says he was not surprised that physicians routinely interrupt patients, and he thought the time to interruption was much shorter than 22 seconds. Stern was also not taken aback by the fact that, given the chance to speak, patients took only two minutes to express their concerns.

"The patients were probably so shocked that the physician hadn't stopped them that they worried they said something wrong," and stopped in confusion after two minutes, he says, only half-jokingly. "I'm not surprised they didn't go on. You can say a lot in two minutes."

In today's managed-care environment, physicians are very conscious of how much time they spend with each patient, Stern says, hence the tendency to interrupt. However, he still recommends doctors spend some time listening: "Up to five minutes, let them go. You'll find all sorts of information."

The British Medical Journal issue containing Langewitz' study is devoted to the question of defining a good doctor and how you make one.

More than 100 people from 24 countries responded to queries as to what constitutes a good physician. People listed a variety of qualities, including compassion, understanding, honesty and competence. A large number of respondents felt there were many good doctors, and the main way to be a good doctor is simply to be a good human being.

As to how to create a good doctor, most people were stumped by this, although the majority felt health-care systems were failing to produce them. A number of people, physicians included, were of the opinion that society undervalues doctors.

What To Do

Read more in the special issue of the British Medical Journal.

For tips on how to best communicate with your doctor, try Ohio State University Medical Center.

SOURCES: Wolf Langewitz, M.D., executive director, division of psychosomatic medicine, department of internal medicine, University Hospital, Basle, Switzerland; David Stern, M.D., associate professor, internal medicine, and assistant director, doctor-patient communication course, University of Michigan, Ann Arbor; Sept. 28, 2002, British Medical Journal
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